Long-term outcome of laparoscopic retroperitoneal nephropexy.
OBJECTIVE
Laparoscopy has been reported recently as a minimally invasive approach for nephropexy. We evaluated our long-term outcomes and quality of life (QoL) after laparoscopic retroperitoneal nephropexy (LRNP).


METHODS
Forty-eight patients with symptomatic nephroptosis with a mean age of 36.2 years underwent LRNP between February 1993 and October 2004 in two German centers. Preoperatively, intravenous urography (IVU) and a renal scan were performed in supine and upright positions. Postoperatively, the IVU and renal scan were repeated. The patients were asked after a median follow-up of 8.16 years for long-term postoperative outcome with a mailed questionnaire about their QoL, symptoms, and whether they would undergo the operation again.


RESULTS
No major intraoperative complications were observed. The mean operative time was 95 minutes (range 50-200 min). The median blood loss was less than 50 mL. Postoperatively, 94.1% of the kidneys radiographically showed no ptosis or ptosis less than one vertebral body. We were able to contact 41 of 48 (85.4%) patients, of whom 95% had no objective symptoms after the operation and 91% had an improvement of their pain symptoms. Of the contacted patients, 70.7% reported an improvement in their QoL and 87% would undergo the operation again.


CONCLUSIONS
LRNP is a minimally invasive, suitable, established method for managing symptomatic nephroptosis with good long-term clinical outcomes and patient satisfaction. This approach also improves patients' perceived QoL.
Gözen
Ali S
AS
Department of Urology, SLK-Kliniken Heilbronn, Teaching Hospital of the University of Heidelberg, Heidelberg, Germany.
Rassweiler
Jens J
JJ
Neuwinger
Frank
F
Bross
Stephan
S
Teber
Dogu
D
Alken
Peter
P
Hatzinger
Martin
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D009392:Nephrectomy; D011182:Postoperative Care; D011300:Preoperative Care; D011788:Quality of Life; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014567:Urography